In this study we are evaluating the outcome in management of distal radius fracture by closed reduction and percutaneous 5 k-wire fixation in both young and elderly patients in most types of distal radius fracture types where closed reduction is possible and where ulna is intact or reconstruct able. Material and Methods: A total of 50 patients with distal end radius fractures associated with or without other fracture were treated in in the department of Orthopaedics at all hospitals attached to SMS Medical College & Hospital, Jaipur. The patients were treated with closed reduction and 5 k-wire (1.8mm) fixation under anaesthesia. Clinical scoring system of green and o'brein modified by Cooney and Sarmiento's modification of Lindstorm criteria was recorded. Results: The most commonly encountered complications were superficial pin tract infection (25.5%) and extensor tendon tethering (6.4%) which were less serious complications and resolved completely on removal of k -wires. Cooney modification of Green and O' Brien's score was showed higher excellent case (84%) than good (10%) and fair (6%) Conclusion: According to our study perfect closed reduction and five k-wire fixation technique is a versatile tool which provides functional outcomes better than conventional k-wire fixation and volar plating in distal end radius fractures.

The purpose of our study is to describe our experience with the non-vascularised fibular autogenous grafts that was used for the treatment of nonunion of long bones including tibia, femur & humerus and to analyse and compare the results in terms of postoperative wound infection, radiographic evidence of union, postoperative pain and functional disability, success rate of procedure etc. with conventional iliac crest bone grafting and plating, at a tertiary care centre. Methods: The study was conducted in department of Orthopedics SMSMC, Jaipur from September 2017 to June 2019 and included 80 cases of nonunion of long bone. Amongst these, 40 cases were treated with fibular strut grafting and 40 cases were treated with iliac crest bone grafting, and all cases were followed postoperatively to compare the results in terms of demographic parameters, union time, postop complications. Result: Amongst 32 cases of nonunion of long bones treated with fibular strut 31 cases (96.9%) showed complete union in mean time interval of 17.77 weeks while only 29 (85.3 %) amongst 34 cases treated with iliac crest bone graft showed union in mean time of 18.41 weeks. Graft site pain was noted in 20.6% cases of iliac crest graft while no cases of fibular strut graft had this problem; EHL weakness was noted in 34.4% of cases and all of them recovered fully at the end of follow up. Conclusion:According to our study fibular strut is a better option in treatment of nonunion long bones as maximum cases showed complete union in less time interval and with very few postoperative complications than iliac crest bone grafting.

Background: The fracture of distal femur are often unstable and comminuted and as difficult to treat. The incidence of complications in these fracture are relatively high .The purpose of our study was aimed to compare functional outcome between both column fixations by using distal femoral locking compression pate on lateral side and then using TENS nail on medial side to obtain support of medial column versus lateral distal femoral plate. Methods: We have included 80 patients with distal femur fracture with intercondylar extension in our study. We have treated 40 patients with distal femoral locking compression plate and support of medial wall with TENS nail and 40 patients with distal femoral locking compression plate. There were sixty six males and fourteen females. The average age of the patients was 39.08 ± 11.95 years. All the patients were operated between 3 to 9 days. All patients were followed up at 2th, 6th, 10th weeks, 3 month and 6 month regularly and evaluated for fracture healing, Clinical union was defined as a painless fracture site during full weight bearing. Radiological union was defined as bridging trabeculation across the fracture site on three of four cortices. The final outcome was assessed according to schatzker and Lambert scoring system. Results: The result was excellent in twelve, good in fifteen, fair in ten and poor in one in DFLCP with TENS nail group according to schatzker and Lambert scoring system. The result was excellent in eight, good in twelve, fair in twelve and poor in five in DFLCP group according to schatzker and Lambert scoring system. The average time to Union was 17.7 weeks in DFLCP with TENS nail group and 19.9 weeks in DFLCP group. Complications include superficial wound infection in three patients, secondary osteoarthritis in 17 patients and varus angulation in three patients in DFLCP with TENS nail group. In DFLCP group varus angulation was in eleven patients. Conclusions: The use of TENS nail for medial femoral defect along with distal femoral locking compression plate may eliminate the need of plate on medial side. The varus angulation that occurs with defect is decreased and additional long incision and operative time is avoided.